Reproductive organs are the biological structures that distinguish women from men and play vital roles in reproduction, pregnancy and childbirth.
These organs include the uterus, ovaries, fallopian tubes, cervix and vagina. However, one of the most significant reproductive health challenges affecting women globally—particularly those of African descent—is uterine fibroids.
Uterine fibroids, also known as leiomyomas, are non-cancerous growths that develop in the uterus, mostly during a woman’s childbearing years. Although they are rarely life-threatening, the World Health Organization (WHO) has identified fibroids as a major public health concern for women of reproductive age.
According to WHO, fibroids are benign tumours made up of muscle and fibrous tissue that grow in or around the uterus. Treatment options include medication, non-invasive procedures and surgery, depending on the severity of symptoms and individual health needs.
Research over the years has shown that African women have the highest prevalence of uterine fibroids globally, with the condition associated with significant health complications, economic burden and, in some cases, death.
Available studies indicate that the prevalence of uterine fibroids in Nigeria ranges from 17.9 per cent to 26 per cent. Fibroids account for between 3.2 per cent and 7.8 per cent of all gynaecological cases in the country and make up a large proportion of hysterectomy procedures.
While many women have successfully undergone fibroid surgery to improve their quality of life or enhance their chances of conception, others have lost their lives due to complications arising from the procedure.
One such case is that of Mr Samuel Eze, who lost his wife in 2023 following complications from fibroid surgery. He recalled that she bled to death despite efforts by medical personnel at a hospital in the Ikotun area of Lagos.
Eze said his late wife, who was in her forties, had suffered several miscarriages linked to fibroids and was advised to undergo surgery to improve her chances of having children.
“If I had known my wife would not survive the surgery, we would not have gone ahead with it. But she insisted because she wanted to have her own children,” he said.
Such experiences reflect the painful reality faced by families still mourning loved ones who died during or after fibroid surgery.
According to Prof. Oliver Ezechi, Director of Research at the Nigerian Institute of Medical Research (NIMR), common complications from fibroid surgery include haemorrhage, injury to surrounding organs, anaesthesia-related risks and infections.
Ezechi, who is also a Professor of Maternal, Reproductive and Child Health at Lead City University, Ibadan, stressed that proper pre-operative assessment was critical to identifying potential risks before surgery.
He noted that women often opt for fibroid surgery to improve quality of life, address heavy bleeding and severe pain, resolve fertility challenges or rule out possible malignancy.
“Fibroids are non-cancerous tumours of the womb that can significantly affect women’s reproductive health. They cause symptoms such as heavy menstrual bleeding, pelvic pain and pressure on nearby organs.
“They can also interfere with fertility and pregnancy outcomes, leading to miscarriage or preterm birth. In the hands of incompetent persons, surgery can result in serious complications or death,” he said.
However, Ezechi noted that mortality from fibroid treatment could be reduced through the use of advanced medical options.
He explained that alternatives to surgery include hormonal therapies such as Gonadotropin-Releasing Hormone (GnRH) agonists, uterine artery embolization, MRI-guided focused ultrasound and endometrial ablation, depending on individual cases.
Each treatment option, he added, has its benefits and risks, and the choice should be guided by medical evaluation and patient preference.
A Consultant Obstetrician and Gynaecologist, Dr James Odofin, said many complications linked to fibroid surgery were not always due to the procedure itself but could result from untreated underlying medical conditions.
He emphasized the need for thorough pre-operative evaluation before any elective surgery.
“Patients with conditions such as hypertension or chronic illnesses that are not well managed before surgery are at higher risk of complications, even during routine procedures,” Odofin said.
The consultant at the Federal Medical Centre, Ebute-Metta, Lagos, noted that fear of surgery often caused patients to delay seeking medical help, leading to late presentation and increased risk.
He urged women to seek early medical attention from qualified specialists and called on the government to improve access to quality healthcare and advanced treatment options to reduce deaths associated with fibroid procedures.
